[Hypolipoproteinemia and secondary role of atherosclerosis in the development of ischemic heart disease in patients with polycythemia vera].

Relationship between presence of coronary heart disease (CHD), coronary risk factors (parameters of lipid transport system and hypertension) and disturbances of microcirculation was studied in patients with myeloproliferative blood disease Polycythemia Vera (PV). Probability of tissue (including blood vessel wall) cholesterol accumulation was estimated by measurement of its content in skin surface layers. PV patients (n=55, including 27 patients with CHD) had predominant hypolipoproteinemia with normal proportion of various lipoprotein classes. Absence of substantial increase of skin surface cholesterol content both in patients with and without CHD was considered to be a sign of low probability of the presence of severe atherosclerotic processes. However patients with CHD had substantially more pronounced disturbances of microcirculation. Basing on these data the authors suggest that CHD in PV patients had non-lipoprotein genesis and present discussion of alternative mechanisms of vascular changes.

[Relation between resistance to oxidation and cholesterol acceptance of high density lipoproteins in patients with ischemic heart disease]. / Vzaimosviaz' mezhdu okislitel'noi ustoichivost'iu i kholesterin-aktseptornoi sposobnost'iu lipoproteinov vysokoi plotnosti u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Cholesterol (CH) acceptance ability of high density lipoproteins (HDL) was assessed in 43 ischemic heart disease (IHD) patients, including patients with post-infarction cardiosclerosis and class II-III effort angina. CH acceptance ability of HDL was measured as increment of HDL CH after incubation with artificial CH-containing system. Oxidabilities of HDL and total plasma were estimated by quantitation of lipid peroxidation products (hydroperoxides and thiobarbituric acid-reactive substances - TBARS) after incubation with Cu(2+) ions. HDL fraction (after apo B lipoproteins removal) of IHD patients appeared to include 2 times less additive CH compared with donor's HDL despite lower (-12%) HDL CH level. Negative correlation (r =-0.38, p<0.05) existed between formed TBARS in HDL and HDL CH acceptance. In total plasma of IHD patients elevation of both formed TBARS and particularly hydroperoxides was observed. Parallelism between decrease of CH acceptance by HDL, oxidability of HDL and of total plasma testifies on weakness not only of CH-accepting, but also of antioxidant HDL functions in IHD patients.

[The way of evaluation of cholesterol accepting capacity of plasma high density lipoproteins]. / Sposob otsenki kholestrin-aktseptornoi emkosti lipoproteinov vysokoi plotnosti plazmy krovi.

The simple way of quantitative evaluation of high density lipoproteins (HDL) capacity to absorb additive cholesterol quantity is proposed. It allows to evaluate indirectly intensity of the first, rate limiting stage of reverse cholesterol transport its accepting from the cells by means of HDL. The way includes the usage of stable artificial cholesterol donor--cholesterol covered inert polymer particles, which are than more convenient, than cell culture use. The total HDL rough fraction (i.e. serum after apoB lipoproteins removal) was shown to include more than 50% cholesterol in addition to yet presenting amount. But this ability is sharply reduced, or sometimes even is completely absent, in HDL of 63 coronary heart disease (CHD) patients (as compared with 41 healthy donors). This difference of potential cholesterol accepting capacity is revealed even at the same initial HDL concentrations. The negative correlation (r = - 0.32, p < 0.05) between this HDL property (delta HDL cholesterol) and their oxidability in the ions Cu2+ presence was observed. This underlines atherogenic role of HDL oxidability. The treatment of patients by phospholipids (as Lipostabyl) resulted to recovery of HDL cholesterol accepting capacity. The possible mechanisms of junction of this HDL activity with their oxidability are discussed, as well as necessity of evaluation of HDL properties and reverse cholesterol transport for the choice of care strategy of CHD patients.

[Characteristics of the lipid transport system in psoriasis]. / Osobennosti lipid-transportnoi sistemy pri psoriaze.

Cholesterol of high density lipoprotein (HDL) subfractions (HDL2 and HDL3), activity of cholesterol ester transport protein (CETP), and standard lipoprotein parameters (cholesterol, triglycerides, HDL cholesterol) were measured in plasma of 192 patients with various psoriasis forms, which included simple "distributed psoriasis", erythrodermic and arthropathic psoriasis. Among psoriatic patients unusually high percent of persons with both hypo- and hyper-cholesterolemia was observed. The same situation was observed with frequency of cases with both low and high plasma HDL cholesterol levels, the distribution being depending from disease severity. In contrast to norm, psoriasis patients had big range not only in HDL2 cholesterol level, but also in HDL3 cholesterol. They also had decreased CETP activity. Data obtained suggest the existence of changes in reverse cholesterol transport system in psoriasis, which may influence skin cell proliferation (via control of cell supply with cholesterol).

[Features of distribution of free and esterified cholesterol in the epidermis, biological membranes and plasma lipoproteins in psoriasis]. / Osobennosti raspredeleniia svobodnogo i éterifitsirovannogo kholesterina v épidermise, biomembranakh i lipoproteidakh plazmy pri psoriaze.

The parameters of cholesterol (CS) metabolism in the epidermis, blood plasma lipoproteins, and red cell membranes were assessed in patients with psoriasis. The levels of free and total CS in extracts from the surface of epidermis, in plasma lipoproteins, and in plasma triglycerides were measured, and the molar ratio CS/ phospholipids (CS/PL index) in red cell membranes assessed in 194 patients with psoriasis of different severity. The levels of free and total CS in the epidermis were found to increase as the psoriatic process grew in severity. These shifts manifested even in apparently intact skin sites, which indicated the primary nature of total-system disorders. As for the plasma lipids, statistically reliable changes were observed only for the relative level of free cholesterol of the plasma and, most of all, high-density lipoproteins. These values for the mean parameters in the five groups of examinees correlated (r from 0.71 to 0.92) with the levels of total and free CS in the epidermis. Contrary to it, the levels of total CS and triglycerides in the plasma had a tendency to decrease as the severity of the psoriatic process augmented. Such a trend was statistically reliable for the CS/PL index, which increased in all the patients except the most grave, this increase being the more, the less grave the disease was; this was manifested in an inverse correlation (r = 0.9, on average) with the epidermal CS. The detected uncommon relationship between CS values in the epidermis, plasma lipoproteins, and biological membranes indicates heretofore unknown features of metabolic disorders in psoriasis.

[The antiatherogenic action of plant oils with added omega-3 polyunsaturated fatty acids]. / Antiaterogennoe deistvie rastitel'nykh masel s dobavkoi omega-3 polinenasyshchennykh zhirnykh kislot.

Quick model of experimental atherosclerosis--3 weeks of cholesterol feeding and 3 weeks of standard diet for aorta atheromatosis development--was used in rabbits. Then one group of animals was fed 1 month by plant oil of specific composition, with added omega-3 (linolenic) fatty acid, and the other group received the same dose of fish oil. The most intensive decrease of plasma cholesterol and erythrocyte cholesterol/phospholipid ratio was in rabbits, that received the oil with linolenic acid. Triglyceride level decreased gradually in all animal groups in the same degree, and HOL cholesterol did not change. After the end of experiment the aorta damage degree in group, that received plant oil with linolenic acid, was only 10.8%, as compared with 36.2% in control group (without treatment) and 39.3% in rabbits, that received fish oil. The absence of fish oil effect supports the earlier data about rabbits specific sensitivity to this product resulting in possible hepatotoxic effect. The data indicates on the usefulness of rabbit model in fish oil effects investigations, and also on the positive, antiatherogenic effect of plant oil with added linolenic acid.

[A trial of the clinical use of the Russian hypocholesterolemic preparation fenbutol--an analog of probucol]. / Opyt klinicheskogo primeneniia otechestvennogo gipokholesterinemicheskogo preparata fenbutola--analoga probukola.

Phenbutol, a Russian analogue of probucol, was studied by the single blind method by using placebo in 30 patients aged 36 to 65 years whose total serum cholesterol levels were more than 250 mg/dl after a month placebo therapy. The patients were divided into two groups: (1) 15 patients on placebo and (2) 15 patients on phenbutol, 500 mg twice a day for 5 months. Blood lipid parameters were monthly determined. The findings are in agreement with the data on the effects of probucol on lipids and its adverse effects. During the follow-up, phenbutol showed 17%, 14% and 10% decreases in total cholesterol and low density lipoprotein cholesterol and high density lipoprotein cholesterol, respectively, as compared with the baselines. These changes were greater than those in patients on placebo. In the first week of therapy with phenbutol, vomiting, appetite decrease, digestive disturbances were observed in 73% of patients. These adverse reactions did not require its withdrawal. Resting ECG Q-T interval became prolonged in 7 out of 15 patients receiving phenbutol (maximum 500 msec).

[Antiatherogenic action of corn oil in experimental atherosclerosis]. / Antiaterogennoe deistvie kukuruznogo masla pri éksperimental'nom ateroskleroze.

Therapeutic effect of corn oil was studied in rabbits with alimentary atherosclerosis. Corn oil was administered (2 ml/kg, 30 days) after the completion of cholesterol diet unlike studies, where they were administered simultaneously. Total cholesterol, apoB-lipoprotein cholesterol and triglycerides decreased more intensively in rabbits fed by corn oil than in control group. No changes in high-density lipoprotein cholesterol were observed. The most pronounced effect was noted in aorta morphological analysis: an aorta damage degree was 4.8% as compared with 52.9% in the control group. The results show that available plant oils with omega-6 polyunsaturated fatty acids (PUFA), in particular corn oil, may as well as omega-3 PUFA be used as the base for antiatherogenic preparations.

[Specificity of the effect of polyene phosphatidylcholine depending on the mode of administration and animal species]. / Spetsifichnost' éffekta polinenasyshchennogo fosfatidilkholina v zavisimosti ot sposoba vvedeniia i vida zhivotnogo.

The effects of polyene phosphatidylcholine (PPC) treatment at oral and intravenous administration to rats and rabbits in hypercholesterolemic diet were studied. No aorta damage was observed in either of rat groups. But fatty liver appeared, and it was the greatest in rats, who received cholesterol and PPC. The result may be attributed to adaptive protection of peripheral tissues due to high experiment duration (18 months) in the state of active reverse cholesterol transport (RChT). No antiatherogenic effect was noted in rabbits at PPC administration (170 mg/kg), while its intravenous injection (50 mg/kg) resulted in marked reduction of plasma cholesterol level, elevation of HDL cholesterol and decrease of the extent of aorta damage. The conclusion is drawn on the ppc high antiatherogenic effect predominantly at intravenous administration, and on advisability of its use in cases of RChT deficiencies, as its activator.

[Changes in the levels and composition of lipoproteins and apolipoproteins of blood plasma in patients with ischemic heart disease after hemosorption]. / Izmenenie kontsentratsii i sostava lipoproteidov i apoproteinov plazmy krovi u bo'lnykh ishemicheskoi bolez'niu serdtsa posle gemosorbtsii.

Prior to and following activated charcoal hemosorption, concentrations of lipids, apolipoproteins AI and B and lipid and protein composition in lipoprotein fractions isolated by ultracentrifugation were determined in the plasma from patients with coronary heart disease. The majority of the patients showed a parallel proportional decrease in plasma atherogenic parameters and all components of very low density lipoproteins and low density lipoproteins, triglycerides in particular. Antiatherogenic parameters, such as high density lipoprotein and apo-AI cholesterol, and all the components in high density lipoprotein subfractions were less reduced. In 19% of the patients, hemosorption failed to affect plasma lipids and apolipoproteins. The findings suggest that, in case of successful hemosorption, apoB-containing lipoproteins are chiefly eliminated as whole complexes from the plasma and that this procedure is most beneficial in hypertriglyceridemia.

[The effect of hemosorption repeated three times on activity of lecithin cholesterol acyltransferase]. / Issledovanie vliianiia trekhkratnoi gemosorbtsii na aktivnost' letsitinkholesterinatsiltransferazy.

Activity of lecithine-cholesterol acyltransferase (LCAT) was studied in blood of 26 patients with atherosclerosis of various localization after course of treatment involving three-fold hemosorption. The initial activity of the enzyme, decreased distinctly as compared with normal state, was dissimilarly altered during hemosorption. The system LCAT-HDLP was stabilized after the third hemosorption. These results relevant to programming hemosorption therapy of patients with atherosclerosis.

[Effect of the plasma lipoprotein spectrum on the cholesterol level in erythrocyte membranes]. / Vliianie spektra lipoproteidov plazmy krovi na uroven' kholesterina membran éritrotsitov.

Correlation between main patterns of the lipoprotein spectrum in blood plasma and the molar ratio cholesterol/phospholipids (Ch/Pl) in erythrocyte membranes was studied in 256 patients. Distribution of Ch/Pl values was shifted to the right side in the plot for erythrocytes of patients with ischemic disease as compared with healthy persons. The values of the Ch/Pl ratio were increased in hypercholesterolemia. There was no statistically distinct correlation between the Ch/Pl ratio and content of cholesterol and triglycerides in blood plasma as well as with concentration of cholesterol in high density lipoproteins (HDL). At the same time, the ratio Ch/Pl of erythrocytes correlated positively with the index of lipoprotein atherogeneity (kath, total Ch-ChHDL/ChHDL) within the values up to 8.0. Within the higher values the correlation disappeared (a plateau was noted on a plot describing this dependence); no distinct correlation was described in all the groups studied. The data obtained suggest that correlation between the rates of cholesterol introduced and removed from the membranes by means of individual classes of lipoproteins is very important for maintenance of the cholesterol content in erythrocyte membrane. Under conditions of high kath values the discorrelation may indicate the saturation of the erythrocyte membranes with cholesterol and a decrease in the rate of its removal by means of HDL.

[Relation between blood levels of thyroid hormones and insulin and lipid metabolism and the clinical course of chronic forms of ischemic heart disease]. / Vzaimosviaz' mezhdu soderzhaniem v krovi tireoidnykh gormonov, insulina, obmenom lipidov i klinicheskim techeniem khronicheskikh form ishemicheskoi bolezni serdtsa.

Ninety patients aged 41 to 68 years with the chronic patterns of coronary heart disease (CHD) were examined for the content of triiodothyronine (T3), total T4 and free thyroxine (FT4), thyrotropic hormone (TTH), adrenocorticotropic hormone (ACTH), and insulin. At the same time the patients were examined with the aid of the glucose tolerance test, determination of blood concentration of cholesterol, triglyceride, high density lipoprotein cholesterol, fibrinogen and soluble fibrin. The patients with CHD showed a decrease in the basal level of T3, T4, FT4 and elevation of TTH, ACTH and insulin in blood. A correlation was found between the basal of insulin and thyroid hormones and lipid metabolism in CHD patients. It was shown that thyroid hypofunction, unmarked clinically but detectable by the lowering of the content of thyroid hormones and rise of thyrotropic hormone in blood of CHD patients, might promote the development of hyperinsulinemia.

[Effect of probucol on lipid metabolism and the clinical course of ischemic heart disease and arteriosclerosis obliterans of the vessels of the lower extremities]. / Vliianie probukola na lipidnyi obmen i klinicheskoe techenie ishemicheskoi bolezni serdtsa i obliteriruiushchego ateroskleroza sosudov nizhnikh konechnostei.

Thirty-eight men with chronic coronary heart disease (CHD) aged 38 to 65 years (ten patients with attendant obliterating atherosclerosis of lower extremity vessels) were treated with the hypolipidemic drug probucol in a dose of 1000 mg/day for three months. Probucol exerted a beneficial effect on the clinical course of CHD and obliterating atherosclerosis of the lower limb vessels. The drug has a marked hypocholesterolemic effect in CHD patients with high cholesterol levels in the blood serum which warrants the advisability of its use in type IIa and IIb hyperlipoproteinemia. The probucol therapy is associated with a decrease in the cholesterol/erythrocyte membrane phospholipids molar ratio which improves the rheological properties of the blood in CHD patients. The drug produces no side effects.

[Characteristics of dyslipoproteinemia in patients with peripheral atherosclerosis]. / Kharakteristika dislipoproteidemii u bol'nykh perifericheskim aterosklerozom.

Reverse correlation between content of cholesterol in lipoproteins of high density (LPHD) and severity of clinical manifestations was observed in patients with obliterating atherosclerosis of legs. Concentrations of cholesterol, triglycerides and LPHD cholesterol were normal in the majority of patients but dyslipoproteinemia of various types including hypo-alpha-lipoproteinemia, was noted in some patients. The molar ratio "cholesterol/phospholipids" was increased in erythrocytes of the patients examined, demonstrating the disbalance in cholesterol turnover between the cell membranes and blood lipoproteins.